IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF TEXAS DIVISION Supplement to JS 44 Civil Cover Sheet Cases Removed from State District Court This form must be filed with the Clerk's Office no later than the first business day following the filing of the Notice of Removal. Additional sheets may be used as necessary. The attorney of record for the removing party MUST sign this form. STATE COURT INFORMATION: 1. Please identify the court from which the case is being removed; the case number; and the complete style of the case. 2. Was jury demand made in State Court? Yes No If yes, by which party and on what date? Party Name Date STATE COURT INFORMATION: 1. List all plaintiffs, defendants, and intervenors still remaining in the case. Also, please list the attorney(s) of record for each party named and include the attorney's firm name, correct mailing address, telephone number, and fax number (including area codes). TXWD - Supplement to JS 44 (Rev. 10/2004) American LegalNet, Inc. www.FormsWorkflow.com 2. List all parties that have not been served at the time of the removal, and the reason(s) for non-service. 3. List all parties that have been non-suited, dismissed, or terminated, and the reason(s) for their removal from the case. COUNTERCLAIMS, CROSS-CLAIMS, and/or THIRD-PARTY CLAIMS: 1. List separately each counterclaim, cross-claim, or third-party claim still remaining in the case and designate the nature of each such claim. For each counterclaim, cross-claim, or third-party claim, include all plaintiffs, defendants, and intervenors still remaining in the case. Also, please list the attorney(s) of record for each party named and include the attorney's firm name, correct mailing address, telephone number, and fax number (including area codes). VERIFICATION: Attorney for Removing Party Date Party/Parties TXWD - Supplement to JS 44 (Rev. 10/2004) American LegalNet, Inc. www.FormsWorkflow.com